The effects of educational interventions on suicide: A systematic review and meta-analysis

Abstract

Background: Suicide is a major public health problem. Educational interventions for preventing suicidal behaviour are widely used, although little is known regarding the collective effectiveness of these interventions. Aim: We evaluated the existing evidence for the effectiveness of education interventions in the prevention of suicidal behaviour. Methods: In this systematic review and meta-analysis, we searched multiple databases using terms related to suicide prevention. The articles were reviewed by two independent reviewers, and the quality of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data from individual studies were combined in meta-analyses. Results: We identified 41 studies evaluating two different types of interventions: school-based education interventions and gatekeeper training. Education interventions showed significant gains in terms of knowledge and attitudes, though the effects seem to vary depending on subjects’ personal characteristics. School-based education interventions significantly reduced suicidal ideation and suicide attempts in youths. Gatekeeper training showed no significant effect on suicide attempts or gatekeeper skills, though the quality of evidence for the estimate, according to GRADE criteria, was rated as very low. Conclusion: The results of this study indicate that school-based education interventions are effective in preventing suicidal ideation and suicide attempts. In clinical practice, as well as in research, the development and implementation of educational interventions should focus on participants’ individual characteristics.

Mismatches in the production of a scoping review: Highlighting the interplay of (in)formalities

“…The purpose of the systematic literature review was “to describe the state of knowledge specifically concerning educational and awareness raising interventions to prevent suicide and the effects of these interventions on suicide‐related outcomes” (Project plan, June 22, 2016). The systematic literature review was supposed to include an initial scoping review, mapping studies evaluating educational and awareness raising interventions, and ultimately a synthesis of research (the systematic review is published elsewhere). This paper will focus on the initial scoping review process of this project.…”

Suicide Prevention Education Within Youth Work Higher Education

“…Students' experiences of not knowing and uncertainty can create anxiety, and the potential to rely on technical, detached responses. The attributes of feeling prepared, confident, and knowledgeable are often assessed in suicide prevention education research with a heavy reliance on self-report; these assessments show the effects of education varying widely (Pistone et al, 2019). Some participants in the present study deemed the content knowledge afforded during the course insufficient, and identified a need to know more.…”

“…Yet no single curriculum, learning activity, or classroom can fully prepare child and youth care practitioners for the complexities of being with children, youth, families, and communities in diverse contexts (Fewster, 2004). As Pistone et al (2019) suggested, "Although education has been statistically shown to increase knowledge and attitudes, the practical relevance of this increase is largely unknown at present. A gain in knowledge is only relevant if it leads to an actual change in behaviour" (p. 410).…”

Military suicide prevention: The importance of leadership behaviors as an upstream suicide prevention target

“…Previous military suicide interventions have attempted to implement improved screening (Curley et al, 2019), clinic‐based care (Rudd et al, 2015), or peer‐to‐peer intervention training (Knox et al, 2003). As of yet, these interventions may be limited in reach as they rely on soldiers self‐referring for care or in the case of peer‐to‐peer training, have demonstrated mixed results (Pistone et al, 2019), and require better evaluation (Isaac et al, 2009). The current study provides evidence for a promising target for a primary prevention effort that identifies and leverages existing military leadership behaviors that align with known protective factors of suicide.…”